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Revista de Medicina de Laboratorio 00129 / http://dx.doi.org/10.20960/revmedlab.00129

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Revisiones - Metaanálisis

Utilidad del PSA en el cribado del cáncer de próstata en la perspectiva de la medicina personalizada

Xavier Filella

Prepublicado: 2022-08-29

Publicado: 2022-09-15

VOLUMEN 3, NÚM. 2, mayo-agosto (2022), PAG. 63-73

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En 2012, el US Preventive Services Task Force recomendó no realizar el cribado del cáncer de próstata basado en PSA debido a la escasa o nula reducción en la mortalidad específica por cáncer de próstata y a los daños relacionados con la evaluación y los posibles tratamientos, que podrían ser innecesarios. Sin embargo, los abordajes restrictivos pueden retrasar el diagnóstico, con la consiguiente migración de la enfermedad a estadios más avanzados. Asimismo, recientemente ha habido cambios que han llevado a repensar la estrategia del cribado del cáncer de próstata más allá de la dicotomía entre cribar a todos los sujetos o a nadie. De hecho, actualmente existen nuevas herramientas para definir una estrategia más eficiente. En primer lugar, debemos mencionar la vigilancia activa, encaminada a reducir el sobretratamiento de la enfermedad. En segundo lugar, debemos señalar las herramientas de estratificación de riesgo y los nuevos biomarcadores relacionados con la agresividad del tumor. En tercer lugar, cabe destacar la aportación de la resonancia magnética multiparamétrica, ya que permite realizar la biopsia solo en aquellos individuos con una alta probabilidad de presentar un tumor. Finalmente, varios estudios subrayan la utilidad de un PSA basal para predecir el futuro diagnóstico del cáncer de próstata. Con base en todos estos cambios, la European Association of Urology recomienda actualmente una estrategia personalizada de cribado del cáncer de próstata.

Palabras Clave: PSA. Cribado. Cáncer de próstata. Medicina personalizada.

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